Background Adherence to oral anticoagulant therapy in patients with atrial fibrillation (AF) in China is low. Patient preference, one of the main reasons for discontinuation of oral anticoagulant therapy, is an unfamiliar concept in China. Methods and findings A discrete choice experiment (DCE) was conducted to quantify patient preference on 7 attributes of oral anticoagulant therapy: antidote (yes/no), food–drug interaction (yes/no), frequency of blood monitoring (no need, every 6/3/1 month[s]), risk of nonfatal major bleeding (0.7/3.1/5.5/7.8[%]), risk of nonfatal stroke (ischemic/hemorrhagic) or systemic embolism (0.6/3.2/5.8/8.4[%]), risk of nonfatal acute myocardial infarction (AMI) (0.2/1.0/1.8/2.5[%]), and monthly out-of-pocket cost (0/120/240/360 RMB) (0 to 56 USD). A total of 16 scenarios were generated by using D-Efficient design and were randomly divided into 2 blocks. Eligible patients were recruited and interviewed from outpatient and inpatient settings of 2 public hospitals in Beijing and Shenzhen, respectively. Patients were presented with 8 scenarios and asked to select 1 of 3 options: 2 unlabeled hypothetical treatments and 1 opt-out option. Mixed logit regression model was used for estimating patients’ preferences of attributes of oral anticoagulants and willingness to pay (WTP) with adjustments for age, sex, education level, income level, city, self-evaluated health score, histories of cardiovascular disease/other vascular disease/any stroke/any bleeding, and use of anticoagulant/antiplatelet therapy. A total of 506 patients were recruited between May 2018 and December 2019 (mean age 70.3 years, 42.1% women). Patients were mainly concerned about the risks of AMI (β: −1.03; 95% CI: −1.31, −0.75; p < 0.001), stroke or systemic embolism (β: −0.81; 95% CI: −0.90, −0.73; p < 0.001), and major bleeding (β: −0.69; 95% CI: −0.78, −0.60; p < 0.001) and were willing to pay more, from up to 798 RMB to 536 RMB (124 to 83 USD) monthly. The least concerning attribute was frequency of blood monitoring (β: −0.31; 95% CI: −0.39, −0.24; p < 0.001). Patients had more concerns about food–drug interactions even exceeding preferences on the 3 risks, if they had a history of stroke or bleeding (β: −2.47; 95% CI: −3.92, −1.02; p < 0.001), recruited from Beijing (β: −1.82; 95% CI: −2.56, −1.07; p < 0.001), or men (β: −0.96; 95% CI: −1.36, −0.56; p < 0.001). Patients with lower educational attainment or lower income weighted all attributes lower, and their WTP for incremental efficacy and safety was minimal. Since the patients were recruited from 2 major hospitals from developed cities in China, further studies with better representative samples would be needed. Conclusions Patients with AF in China were mainly concerned about the safety and effectiveness of oral anticoagulant therapy. The preference weighting on food–drug interaction varied widely. Patients with lower educational attainment or income levels and less experience of bleeding or stroke had more reservations about paying for oral anticoagulant therapies with superior efficacy, safety, and convenience of use.

Abstract. In light of the prolonged period of social distancing and highly mediated communication patterns during the COVID-19 pandemic, this study sought to understand how pandemic-related fear affects social connectedness. Drawing from the Internet-enhanced self-disclosure and fear-eliciting affiliation hypotheses, survey findings from a stratified sample collected among Hong Kong university students ( N = 310) revealed that pandemic-related fear positively influences social connectedness not only through self-disclosure but also through the combination of information seeking and self-disclosure. Social interaction, however, does not mediate the relationship between fear and social connectedness on its own. Overall, we argue that fear motivated people to seek information, self-disclose, and articulate connectedness with society. During this process, social media provided an essential ground and self-disclosure proved a viable tool. This study demonstrated that negative emotions aroused in crisis situations might result in constructive behaviors, which is contingent on how people react to mitigate the negative consequences.

The aim of the research was to explore the ways that female body image was presented and interpreted on Instagram. Specifically, it aimed to identify how women disseminate their body image on Instagram, examine how viewers respond to women's body image disseminated on Instagram and determine how the women's body image presentation on Instagram influences the viewers' self-perceptions and behavior. To achieve the goal, content analysis was used. The data set consisted of 140 photographs that were collected from hashtags. It was found that body images presented in Instagram highlighted sexuality and attractiveness by emphasizing slim body, long hair, with fewer clothing, followed by photographs communicating business purposes and communicating the ideal body, but only a few photos challenged the majority by creating totally different images, such as women's lifting heavy weights or doing something adventure and wearing a bikini at a larger size. As for the viewers' responses, it was found that most viewers positively respond to body image photographs in Instagram, appreciating wonderful and ideal body image and admiring the transformation. In addition, it was found that many comments show that the viewers are dissatisfied with themselves after comparing their body images with ideal body images. This further suggested self-objectification. As for influence, it was found that the women's body images communicated on Instagram influence the viewers significantly in the following aspects: 1) arousing consciousness and inspiration so as to encourage them to make changes; 2) triggering self-objectification; 3) inspiring use of a new perspective to perceive and expect the body image. The research, nevertheless, was limited in sampling which reduced generalizability of findings.